2021-2022 Verification Worksheet V5

  • Your 2021-2022 Free Application for Federal Student Aid (FAFSA) was selected for review in a process called verification. The law says that before awarding Federal Student Aid, we may ask you to confirm the information you and your parents reported on your FAFSA. To verify that you provided correct information the financial aid administrator at your school will compare your FAFSA with the information on this worksheet and with any other required documents. If there are differences, your FAFSA information may need to be corrected. You and at least one parent must complete and sign this worksheet, attach any required documents, and submit the form and other required documents to the financial aid administrator at your school. Your school may ask for additional information. If you have questions about verification, contact your financial aid administrator as soon as possible so that your financial aid will not be delayed.

  • Student NameStudent ID 
  • Student Email AddressStudent SSN 
  • Cell PhoneParent or Guardian Cell Phone 
  • MM slash DD slash YYYY

  • List below the people in your parent’s household. Please Include:

      Yourself and your parent(s) (including stepparent) even if you don’t live with your parents.
    • Your parents’ other children, if your parents will provide more than half of their support from July 1, 2021 through June 30, 2022, or the children would be required to provide parental information if they were completing a FAFSA for 2021-2022. Include children who meet either of these standards, even if they do not live with your parent(s).
    • Other people if they now live with your parents and your parents provide more than half of their support and will continue to provide more than half of their support through June 30, 2022.

    Include the name of the college for any household member EXCLUDING YOUR PARENT(s) , who will be attending at least half time between July 1, 2021 and June 30, 2022, enrolled in a degree or certificate program. Attach separate sheet for more space.

  • Full NameAgeRelationshipCollege or UniversityWill Be Enrolled at least Half Time? 
  • Full NameAgeRelationshipCollege or UniversityWill Be Enrolled at least Half Time? 
  • Full NameAgeRelationshipCollege or UniversityWill Be Enrolled at least Half Time? 
  • Full NameAgeRelationshipCollege or UniversityWill Be Enrolled at least Half Time? 
  • Full NameAgeRelationshipCollege or UniversityWill Be Enrolled at least Half Time? 

  • The next section contains income information for students and Parents. A copy of tax filers 2019 IRS Tax Return and W-2 Form must be attached to this document. To request a copy of your 2019 Federal Tax Return Transcript or 2019 Wage and Tax Transcript, go to www.irs.gov and click get transcript of your tax records.

  • Table A {Please Include a Copy of Supporting Documents}

  • Child Support ReceivedTotal Amount 
  • Social Security or Disability BenefitsTotal Amount 
  • Welfare benefits (TANF)Total Amount 
  • Untaxed PensionsTotal Amount 
  • Workers’ CompensationTotal Amount 
  • Monetary support (Money received or paid on your behalf for necessities such as food, bills, housing and living allowance, etc.)Total Amount 

  • MUST attach a copy of your W-2 Form(s). {Complete Table B}

  • Employer's Name2019 Amount EarnedW-2 Attached? 
  • Employer's Name2019 Amount EarnedW-2 Attached? 
  • Employer's Name2019 Amount EarnedW-2 Attached? 

  • Parent's Income Information

    ONLY USE BOTH PARENTS INFORMATION IF PARENTS ARE MARRIED

  • Table C {Please Include a Copy of Supporting Documents}

  • Child Support ReceivedTotal Amount 
  • Social Security or Disability BenefitsTotal Amount 
  • Child Support RecievedTotal Amount 
  • Welfare benefits (TANF)Total Amount 
  • Untaxed PensionsTotal Amount 
  • Monetary support (Money received or paid on your behalf for necessities such as food, bills, housing and living allowance, etc.)Total Amount 

  • Attached is a copy of my W-2 Form(s). {Must Complete Table E Below}

  • Employer's Name2019 Amount EarnedW-2 Attached 
  • Employer's Name2019 Amount EarnedW-2 Attached 
  • Employer's Name2019 Amount EarnedW-2 Attached 

  • Section Break

  • Please provide one of the following documents that include the student’s high school completion status when the student will begin college in 2021-2022:

    • A copy of the student’s high school diploma
    • A copy of the student’s final official high school transcript that shows the date when the diploma was awarded.
    • A copy of the student’s General Educational Development(GED) certificate, an official GED transcript that indicates the student passed the exam, or a state-authorized high school equivalent certificate.
    • For students who completed secondary education in a foreign country, a copy of the secondary school leaving certificate” or other similar document.
    • An academic transcript that indicates the student successfully completed at least a two- year program that is acceptable for full credit toward a bachelor’s degree.
    • For a homeschooled student from a state where state law requires the student to obtain a secondary school completion credential for homeschool (other than a high school diploma or its recognized equivalent), a copy of the credential.
    • For a homeschooled student from a state where state law does not require the student to obtain a secondary school completion credential for homeschool (other than a high school diploma or its recognized equivalent), a transcript or the equivalent, signed by the student’s parent or guardian, that lists the secondary school courses the student completed and includes a statement that the student successfully completed a secondary school education in a homeschool setting.

    A student who is unable to obtain the documentation listed above must contact the financial aid office.

  • Identity and Statement of Educational Purpose ( To be Signed at the Institution)

    The student must appear in person at____________________________ to verify his or her identity by (Name of Postsecondary Educational Institution) Presenting a valid government-issued photo identification (ID), such as, but not limited to, a driver’s license, other state-issued ID, or passport. The institution will maintain a copy of the student’s photo ID that is annotated by the institution with the date it was received and reviewed and the name of the official at the institution authorized to collect the student’s ID. In addition, the student must sign, in the presence of the institutional official, the following: Statement of Educational Purpose I certify that I ______________________________________am the individual signing this Statement of (Print Student’s Name) Educational Purpose and that the Federal student financial assistance I may receive will only be used for educational purposes and to pay the cost of attending ________________________for 2021-2022. (Name of Postsecondary Educational Institution) __________________________________ _________________________________________

  • Each person signing below certifies that all of the information reported is complete and correct. The student and one parent whose information was reported on the FAFSA must sign and date.

    WARNING: If you purposely give false or misleading information you may be fined, be sentenced to jail, or both.